Individual
DESIREE MOORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
270 S ORCHARD ST, BOISE, ID 83705-1234
(208) 741-0395
Mailing address
270 S ORCHARD ST STE B, BOISE, ID 83705-1234
(208) 741-0395
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTL-1332
ID
Other
Enumeration date
05/20/2014
Last updated
07/28/2023
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